RANKING THE STATES ON CHILDREN'S HEALTH CARE (COMMONWEALTH FUND)

05/29/2008


The first-ever state-by-state health system "scorecard" to focus on children's health care finds wide differences across the country in the quality of care delivered, as well as disparities in access to services, insurance costs, and health outcomes, among other areas.

According to The Commonwealth Fund report, U.S. Variations in Child Health System Performance: A State Scorecard, millions more children would have insurance and adequate health care, and would avoid developmental delays, if all states performed as well as the top states. Leading the state rankings are Iowa, Vermont, Maine, Massachusetts, and New Hampshire. (View an interactive map to see where your state ranks.)

The report estimates that if all states performed as well as the top states:

  • an additional 4.6 million children nationwide would have health insurance;
  • 11.8 million more children would get their recommended yearly medical and dental check-ups;
  • 1.6 million fewer children would be at risk for developmental delays;
  • 10.9 million more children would have a medical home; and
  • nearly 800,000 more children would be up-to-date on their vaccines.

States are ranked on 13 indicators of access, quality, costs, equity, and healthy outcomes. While no single state performed at the top across all categories, some states far surpassed others. Still, there is room for improvement in even the highest ranked states, the authors found.

"In looking at the country as a whole, we found that, while there are pockets of excellence, there is no one state or region that is doing as well as it could be," said Commonwealth Fund Vice President Edward Schor, M.D., a coauthor of the report. "The good news is we know improvements can be made because we didn't judge these states based on a pie-in-the-sky standard; we judged them against one another."

The Commonwealth Fund is a private foundation that aims to promote a high performing health care system that achieves better access, improved quality, and greater efficiency.